Hospitalization for Community-Acquired Pneumonia in Alberta Patients with Human Immunodeficiency Virus Infection: A Case Control Study

BACKGROUND: To determine whether outcomes of pneumonia among human immunodeficiency virus (HIV)-positive persons differed from those among HIV-negative persons.

METHODS: Alberta hospital patient abstracts for HIV-positive persons requiring hospitalization for pneumonia from April 1, 1994, until March 31, 1999, were matched by age and sex with four HIV-negative counterparts.

RESULTS: Hospitalizations for community-acquired pneumonia decreased for those with HIV (acquired immunodeficiency syndrome [AIDS]) and increased for those with HIV (non-AIDS) during the study period. HIV (AIDS) patients admitted for community-acquired pneumonia (n=130) manifested three times higher odds for a longer length of hospital stay and had three and 10 times higher odds for excess in-hospital and one-year mortality, respectively, than their matched controls. Similarly, HIV (non-AIDS) patients admitted for community-acquired pneumonia (n=46) manifested two times higher odds for a longer length of hospital stay and had four times higher odds for excess one-year mortality than their matched controls. The in-hospital and one-year mortality rates for the HIV (AIDS) patients were 21.2% and 64.3%, respectively, during the first three years, and decreased to 8.7% and 40.7%, respectively, in the last two years of the study.

CONCLUSIONS: The outcomes for community-acquired pneumonia were worse for those with HIV (non-AIDS) and HIV (AIDS) compared with non-HIV hospitalized patients matched for age and sex, and controlling for severity of illness and comorbidity. In-hospital and one-year mortality rates for patients with HIV (AIDS) showed a marked decline over the study period.